{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:40Z","timestamp":1787017060564,"version":"build-2736575974"},"reference-count":49,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010628","name":"Center for Tobacco Products","doi-asserted-by":"publisher","award":["U54CA229974"],"award-info":[{"award-number":["U54CA229974"]}],"id":[{"id":"10.13039\/100010628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["T32CA083654"],"award-info":[{"award-number":["T32CA083654"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2023,4,4]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A better understanding of sociodemographic transition patterns between single, dual and poly tobacco product use may help improve tobacco control policy interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>HRs of transition between never, non-current (no past 30-day use), cigarette, e-cigarette, other combustible, smokeless tobacco (SLT), dual and poly tobacco use states in adults were estimated for age, sex, race\/ethnicity, education and income using a multistate model for waves 1\u20134 of the Population Assessment of Tobacco and Health study (2013\u20132017), a US-based cohort study, accounting for complex survey design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sole cigarette and SLT use were persistent, with 77% and 78% of adults continuing use after one wave. Other use states were more transient, with 29%\u201348% of adults reporting the same pattern after one wave. If single-product users transitioned, it was most likely to non-current use while dual or poly cigarette users were most likely to transition to exclusive cigarette use. Males were more likely than females to initiate combustible product use after a history of no use, and after a period of tobacco use cessation. Hispanic and non-Hispanic black participants initiated cigarette use at higher rates than non-Hispanic white participants, and had higher rates of experimentation with tobacco products between study waves. Lower socioeconomic status was associated with higher rates of transition into combustible tobacco use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dual and poly tobacco use is largely transient, while single-use patterns are more stable over time. Transitions differ by age, sex, race\/ethnicity, education and income, which may influence the impact of current and future tobacco control efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2022-057822","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T13:20:26Z","timestamp":1682342426000},"page":"603-610","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Patterns of poly tobacco use among adults in the Population Assessment of Tobacco and Health (PATH) study, 2013\u20132017: a multistate Markov transition analysis"],"prefix":"10.1136","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7445-322X","authenticated-orcid":false,"given":"Fatema","family":"Shafie Khorassani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3779-5287","authenticated-orcid":false,"given":"Andrew F","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana L","family":"Hirschtick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyoun","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Jimenez-Mendoza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-5037","authenticated-orcid":false,"given":"Rafael","family":"Meza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4371-9133","authenticated-orcid":false,"given":"Nancy L","family":"Fleischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"2024092601251518000_33.5.603.1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health . 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